Impact of prior lenalidomide or proteasome inhibitor exposure on the effectiveness of ixazomib-lenalidomide-dexamethasone for relapsed/refractory multiple myeloma: A pooled analysis from the INSURE study.

Autor: Lee HC; Department of Lymphoma/Myeloma, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA., Ramasamy K; Department of Haematology, Oxford University Hospitals NHS Foundation Trust, Oxford, Oxfordshire, UK., Macro M; CHU de Caen Normandie, Caen, France., Davies FE; Perlmutter Cancer Center, NYU Langone, New York City, New York, USA., Abonour R; Indiana University School of Medicine, Indianapolis, Indiana, USA., van Rhee F; University of Arkansas for Medical Sciences (UAMS), Little Rock, Arkansas, USA., Hungria VTM; Clinica São Germano and Santa Casa Medical School, São Paulo, Brazil., Puig N; Hematology Department, Hospital Universitario de Salamanca (HUSAL), IBSAL, IBMCC (USAL-CSIC), CIBERONC, Salamanca, Spain., Ren K; Takeda Development Center Americas, Inc. (TDCA), Lexington, Massachusetts, USA., Silar J; Institute of Biostatistics and Analyses, Ltd, Brno, Czech Republic., Enwemadu V; Takeda Pharmaceuticals U.S.A., Inc., Lexington, Massachusetts, USA., Cherepanov D; Takeda Development Center Americas, Inc. (TDCA), Lexington, Massachusetts, USA., Leleu X; Pôle Régional de Cancérologie, Department of Hematology, CHU La Milétrie-Poitiers, Poitiers, France.
Jazyk: angličtina
Zdroj: European journal of haematology [Eur J Haematol] 2024 Aug; Vol. 113 (2), pp. 190-200. Date of Electronic Publication: 2024 Apr 23.
DOI: 10.1111/ejh.14214
Abstrakt: Objectives: To characterize the impact of prior exposure and refractoriness to lenalidomide or proteasome inhibitors (PIs) on the effectiveness and safety of ixazomib-lenalidomide-dexamethasone (IRd) in relapsed/refractory multiple myeloma (RRMM).
Methods: INSURE is a pooled analysis of adult RRMM patients who had received IRd in ≥2 line of therapy from three studies: INSIGHT MM, UVEA-IXA, and REMIX.
Results: Overall, 391/100/68 were lenalidomide-naïve/-exposed/-refractory and 37/411/110 were PI-naïve/-exposed/-refractory. Median duration of therapy (DOT) was 15.3/15.6/4.7 months and median progression-free survival (PFS) was 21.6/25.8/5.6 months in lenalidomide-naïve/exposed/refractory patients. Median DOT and PFS in PI-naïve/exposed/refractory patients were 20.4/15.2/6.9 months and not reached/19.8/11.4 months, respectively. The proportion of lenalidomide-naïve/exposed/refractory patients in INSIGHT and UVEA-IXA who discontinued a study drug due to adverse events (AEs) was ixazomib, 31.6/28.2/28.0% and 18.6/6.7/10.5%; lenalidomide, 21.9/28.2/16.0% and 16.1/6.7/10.5%; dexamethasone, 18.4/20.5/16.0% and 10.6/0/10.5%, respectively. The proportion of PI-naïve/exposed/refractory patients in INSIGHT and UVEA-IXA who discontinued a study drug due to AEs was: ixazomib, 44.4/28.8/27.8% and 22.2/16.7/15.7%; lenalidomide, 33.3/22.0/19.4% and 16.7/15.9/11.8%; dexamethasone, 33.3/17.4/16.7% and 16.7/9.5/7.8%, respectively. REMIX AE discontinuation rates were unavailable.
Conclusion: IRd appeared to be effective in RRMM patients in routine clinical practice regardless of prior lenalidomide or PI exposure, with better outcomes seen in lenalidomide- and/or PI-nonrefractory versus refractory patients.
(© 2024 Takeda Pharmaceutical and The Authors. European Journal of Haematology published by John Wiley & Sons Ltd.)
Databáze: MEDLINE
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